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Premium member Presentation Transcript Cestodes : Cestodes -Varun C N Slide 2: Diphyllobothrium latum (Fish tapeworm) Morphology Adult worm Longest tapeworm in humans Has 3 parts- Scolex, neck and strobila Ivory colored Scolex Almond shaped It bears 2 slit like grooves- “Bothria” No rosetellum and hooklets 2 Varun C N- Cestodes Slide 3: Neck Present below the scolex Thin, unsegmented Long in length compared to scolex Strobila More than 3000 proglottids Immature, mature and gravid proglottids Hermaphroditic in nature Eggs are discharged periodically Single worm discharge as many as million eggs/ day 3 Varun C N- Cestodes Slide 4: Egg Bile stained Contains immature embryo Operculated egg Not effective to humans Thin eggs with operculum at one end and knob at other 4 Varun C N- Cestodes Slide 5: Definitive host- Humans First Intermediate host- Small copepods Second Intermediate host- Freshwater fishes Infective form- Plerocercoid larva Mode of infection- Ingestion of Fish containing larval forms 5 Varun C N- Cestodes Slide 6: Water Copepods Fish 6 Varun C N- Cestodes Slide 7: Clinical manifestations Intestinal obstruction, diarrhea, and abdominal pain Pernicious anemia Laboratory diagnosis Demonstration of eggs in fecal samples by Direct examination Concentrated by Formol-ether method 7 Varun C N- Cestodes Slide 8: Prophylaxis Proper cooking Flash freezing of raw fish Effective sanitation Treat the carriers Treatment Praziquantel or Niclosamide 8 Varun C N- Cestodes Slide 9: Taenia saginata and Taenia solium Other name Taenia saginata- Beef tapeworm, unarmed tapeworm of man Taenia solium- Pork tapeworm, armed tapeworm of man Distribution- World wide 9 Varun C N- Cestodes Slide 10: 10 Varun C N- Cestodes Slide 11: 11 Varun C N- Cestodes Slide 12: T. saginata T. solium 12 Varun C N- Cestodes Slide 13: Figure A: Taenia saginata has 15 to 20 uterine branches in each segment (proglottid).Figure B: Taenia solium has 7 to 13 uterine branches 13 Varun C N- Cestodes Slide 14: Eggs: Thick, striated shell. Eggs of T.solium and T. saginata are indistinguishable and species identification should be made from proglottids or scoleces. When excreted Embryonated. 6- hooked oncosphere present inside a thick shell. 14 Varun C N- Cestodes Slide 15: Life cycle 15 Varun C N- Cestodes Slide 16: 16 Varun C N- Cestodes Slide 17: 17 Varun C N- Cestodes Slide 18: Clinical symptoms T saginata produces mild discomfort and abdominal pain T solium larval forms develop in other parts of body and cause related symptoms. The most dangerous is Neurocysticercosis Other organ cysticercosis is also seen 18 Varun C N- Cestodes Slide 19: 19 Varun C N- Cestodes Slide 20: An extraordinary huge cysticercosis pseudo tumour 1.5kg was completely excised. Uledi SJ. A rare gigantic solitary cysticercosis pseudotumour of the neck. JSCR. 2010 9:5 20 Varun C N- Cestodes Slide 21: Lab diagnosis Diagnosis of intestinal taeniasis can be made by recovery of the characteristic ova in the stool. The diagnosis of cysticercosis depends upon serology Calcified cysticerci are less often seen in the brain Calcification in muscles usually appears three to five years after initial infection, and are most typically seen as spindle-shaped calcifications, most numerous in the thighs. Occasionally, the diagnosis is made histologically on surgical specimens. 21 Varun C N- Cestodes Slide 22: Prophylaxis Proper Cooking All Meat consumed should be checked for cysticercosis Proper sanitary disposal Treat all infected people 22 Varun C N- Cestodes Slide 23: Hymenolepis nana (Dwarf tapeworm) H. nana is the most common cause of all cestode infections and is encountered worldwide 23 Varun C N- Cestodes Slide 24: Adult Worm Scolex Globular 4 cup shaped suckers Rosetellum armed with a single row of hooklets Neck Long and slender Strobila About 200 proglottids Hermaphroditic Genital pores are lateral 24 Varun C N- Cestodes Slide 25: Eggs: Non operculated On the inner of the two membranes surrounding are two poles, from which 4 to 8 polar filaments spread out between the two membranes. The oncosphere, or larval stage, has six hooks. 25 Varun C N- Cestodes Slide 26: Life cycle Infectious form: Mature Egg Route of infection: Ingestion Natural Host: Human Reservoir Host; Rats When eaten by a person or rodent, eggs hatch in the duodenum, releasing oncospheres, which penetrate the mucosa and come to lie in lymph channels of the villi. Oncospheres develop into cysticercus larvae which have a neck behind a well formed scolex. In five to six days cysticercoids emerge into the lumen of the small intestine, where they attach, mature, and produce eggs. 26 Varun C N- Cestodes Slide 27: 27 Varun C N- Cestodes Slide 28: Life cycle Direct Indirect 28 Varun C N- Cestodes Slide 29: Clinical symptoms Infections due to H. nana may cause no symptoms even with heavy worm burdens. Restlessness, irritability, anorexia, abdominal pain and diarrhea Heavy worm burdens may be caused by auto-infection which can be a problem in the immunocompromised. Laboratory Diagnosis Diagnosis is based on recovery and identification of the characteristic ova in a Formol-ether concentrate of feces. Adult worms and proglottids are rarely seen in stool samples 29 Varun C N- Cestodes Slide 30: Don’t get Confused. This is not H nana. Its his brother- H diminuta No polar filaments 30 Varun C N- Cestodes Slide 31: Echinococcus granulosus 31 Varun C N- Cestodes Slide 32: Morphology Adult Worm: Scolex: Pyriform in shape 4 suckers and a protrusible rosetellum Double row of hooklets Neck Thick and short Strobila 3 segments- immature, mature and gravid 32 Varun C N- Cestodes Slide 33: Eggs: Morphologically indistinguishable from Taenia species 33 Varun C N- Cestodes Slide 34: 34 Varun C N- Cestodes Slide 35: Life cycle: Definitive hosts- Feline animals Indefinitive hosts- Cattles Accidental hosts- Man Infective form- Mature Eggs Mode of infection- Ingestion Agent causing infection in humans- Larva 35 Varun C N- Cestodes Slide 36: 36 Varun C N- Cestodes Slide 37: Pericyst Ectocyst Endocyst Brood capsules Hydatid Fluid Fig: Structure of Hydatid Cyst 37 Varun C N- Cestodes Slide 38: Hydatid Fluid Clear and pale yellow Sp gravity of 1.005-1.010 pH is slight acidic (aprox 6.7) Highly antigenic Centrifuged deposits of hydatid fluid shows free solices, hooklets and detached brood capsules. It is called as hydatid sand. 38 Varun C N- Cestodes Slide 39: 39 Varun C N- Cestodes Slide 40: Laboratory diagnosis: 1. Casoni Test Man's arm showing positive skin test for hydatid disease 40 Varun C N- Cestodes Slide 41: 2. Serological diagnosis 3. Surgical removal of Hydatid cyst and examination 4. Histology 5. Radio diagnosis 41 Varun C N- Cestodes Slide 42: That’s all………. The End 42 Varun C N- Cestodes You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.